Impact of Malnutrition on the Length of Stay for Hospitalized Chimeric Antigen Receptor T-cell (CAR-T) Therapy Patients in the United States (2020).

Background Chimeric antigen receptor T-cell (CAR-T) therapy offers a promising treatment for certain malignancies but can be associated with complications. Malnutrition and cachexia are common in cancer patients and may worsen outcomes. This study investigated the impact of malnutrition on the length of hospital stay (LOS) in patients with hematologic malignancies undergoing CAR-T therapy.

Clinical outcomes in cystic fibrosis patients with Trichosporon respiratory infection.

Background: Relationships between clinical outcomes and novel respiratory pathogens such as Trichosporon are not well understood.

Methods: Respiratory cultures from CF patients were screened for novel pathogens Trichosporon and Chryseobacterium as well as other pathogens over 28months. Relationships between microbiologic and clinical data were assessed using univariate and multivariate methods.

Ventricular Function Before and After Surgery for Isolated and Combined Regurgitation in the Young.

Background: Chronic mitral and aortic regurgitation (MR and AR) are associated with progressive contractile dysfunction. In the young, the risk of left ventricle (LV) dysfunction after operation for isolated and combined AR and MR is poorly defined. We aimed to compare LV mechanics in children and young adults with isolated and combined AR and MR, and identify risk factors for LV dysfunction after valve surgery.

Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology.

Respiratory viruses are associated with common respiratory pathogens in cystic fibrosis.

Objectives: Test the hypothesis that the link between respiratory viruses and pulmonary exacerbation in cystic fibrosis (CF) reflects increased frequency or severity of lower airways infection.

Study Design: Molecular respiratory viral panels (RVPs), cell counts, and quantitative bacterial cultures were assessed in 235 bronchoalveolar lavage fluid (BALF) samples from 138 children with CF. Relationships among the data were analyzed using multivariate methods.

Arterial switch operation: early and late outcome for intramural coronary arteries.

Background: Intramural coronary artery course (IMCA) is associated with an increased risk of coronary event and mortality after the arterial switch operation (ASO). We describe early and late outcomes at our institution from 1996 to 2006.

Methods: Operation notes for all patients who underwent ASO within 60 days of birth were reviewed, and those with IMCA were identified.

Evolution of testing algorithms at a university hospital for detection of Clostridium difficile infections.

We present the evolution of testing algorithms at our institution in which the C. Diff Quik Chek Complete immunochromatographic cartridge assay determines the presence of both glutamate dehydrogenase and Clostridium difficile toxins A and B as a primary screen for C. difficile infection and indeterminate results (glutamate dehydrogenase positive, toxin A and B negative) are confirmed by the GeneXpert C.

Detection of rapidly growing mycobacteria in routine cultures of samples from patients with cystic fibrosis.

Rapidly growing mycobacteria (RGM) are respiratory pathogens in patients with cystic fibrosis (CF), but detection generally requires specialized cultures for acid-fast bacilli (AFB; AFB cultures). We determined that RGM could be recovered from routine cultures of samples from patients with CF by extending incubation of the Burkholderia cepacia selective agar (BCSA) from 5 to 14 days. To explore the impact of this modification, we compared results from routine and AFB cultures of samples from CF patients for 2 years before (4,212 samples by routine culture, 1,810 samples by AFB culture, 670 patients) and 2 years after (4,720 samples by routine culture, 2,179 samples by AFB culture, 695 patients) the change.

Chronic Mycobacterium abscessus infection and lung function decline in cystic fibrosis.

Background: Although nontuberculous mycobacteria (NTM) are recognized pathogens in cystic fibrosis (CF), associations with clinical outcomes remain unclear.

Methods: Microbiological data was obtained from 1216 CF patients over 8years (481+/-55patients/year). Relationships to clinical outcomes were examined in the subset (n=271, 203+/-23 patients/year) with longitudinal data.

Prevalence of community-associated methicillin-resistant Staphylococcus aureus in patients with cystic fibrosis.

We prospectively determined the prevalence of community-associated Staphylococcus aureus in a large cystic fibrosis (CF) center between October 2005 and October 2007. We found that 2.7% (19/707) of the CF patients who had cultures during the study period were infected with this organism, representing 14% of the total methicillin-resistant Staphylococcus aureus strains (n = 140) recovered from the patient population during the study period.

Steroid receptor and growth factor receptor expression in human nonsmall cell lung cancers using cells procured by laser-capture microdissection.

Few biomarkers exist for management of nonsmall cell lung cancers (NSCLC), although estrogen receptor (ERalpha and ERbeta) and EGF receptor (EGFR) expression has been related to clinical outcome. To circumvent problems of cellular heterogeneity in whole tissue, relative gene expression of ERalpha, ERbeta, EGFR, and HER-2 (c-erb-B2) was examined in pure lung carcinoma (LC) cells and normal epithelia by LCM. Cell-specific RNA was isolated and purified for RT-qPCR and microarray.

Biosensors for detecting estrogen-like molecules and protein biomarkers.

A novel evanescent-based biosensor (Endotect, ThreeFold Sensors, Inc.) was developed with laser-based fiber optics using fluorescent dye-labeled recombinant human estrogen receptor-alpha (rhERalpha) and hERbeta as probes. A three-tiered approach evaluating various steps in the formation of the estrogen-receptor complex and its subsequent activity was developed for instrument calibration to detect estrogen mimics in biological samples, water and soil.

A three-tiered approach for calibration of a biosensor to detect estrogen mimics.

A three-tiered approach was developed to determine the influence of a chemically-diverse group of compounds exhibiting estrogen mimicry using recombinant human estrogen receptor (rhER) activity to calibrate a receptor protein-based biosensor. In the initial tier, a ligand competition array was developed to evaluate compounds inhibiting [3H]estradiol-17beta binding to rhER. Each of six different concentrations of [3H]estradiol-17beta was mixed with increasing concentrations of an unlabeled putative mimic.

Cardiac outcome up to 15 years after the arterial switch operation.

Aims: To assess the cardiac outcome and risk factors for mortality of infants following the arterial switch operation (ASO).

Methods: A single-centre retrospective review was conducted. Preoperative assessment, operative management and outcome was detailed for 244 patients undergoing the ASO at Green Lane Hospital for transposition of the great arteries (TGA) or double outlet right ventricle.

Surgery for acute type a aortic dissection a 37-year experience in Green Lane Hospital.

Purpose: To review the management of patients with acute type A aortic dissection.

Methods: Between June 1967 and December 2003, 246 patients (151 males and 95 females, 20-82 years; median 59 years) underwent operation for type A dissection. Early mortality and aortic dissection-related late events (reoperation and death related to aortic dissection) were assessed and correlated with the surgical approach.

Bacteriological outcome after valve surgery for active infective endocarditis: implications for duration of treatment after surgery.

Background: There has been no systematic evaluation of outcome after surgery for infective endocarditis with respect to duration of antibiotic treatment.

Methods: We performed a retrospective chart review of episodes of valve surgery for active infective endocarditis at Green Lane Hospital (Auckland, New Zealand) for 1963-1999. We recorded the duration of antibiotic treatment before and after valve surgery; the extent of infection at operation; Gram stain, culture, and histopathological testing results for valve samples; and the bacteriological outcome after surgery.

Mild supravalvular aortic stenosis with left coronary obstruction in a neonate.

A premature infant with a large patent ductus arteriosus and mild supravalvular aortic stenosis had evidence of severe myocardial ischemia after ductus ligation. Urgent reoperation was required to relieve severe obstruction of the left coronary orifice and the supravalvular stenosis was repaired. This unusual presentation early in infancy emphasizes that left coronary artery obstruction should be suspected even in the presence of mild supravalvular stenosis.

Frozen chicken nuggets and strips--a newly identified risk factor for Salmonella Heidelberg infection in British Columbia, Canada.

Salmonella enterica var. Heidelberg was isolated from an unusual food source during routine case follow-up, prompting a case control investigation of frozen chicken nuggets and strips. Most frozen nuggets and strips are raw; however, par-frying lends a cooked appearance.

Extracardiac conduit with a limited maze procedure for the failing Fontan with atrial tachycardias.

Background: Atrial arrhythmias are a frequent late complication of Fontan procedures. Conversion to an extracardiac conduit combined with reducing right atrial size should improve hemodynamics and reduce the development of tachyarrhythmias. More effective control may be achieved by interrupting atrial arrhythmia circuits and atrial pacing.

Gram stain, culture, and histopathological examination findings for heart valves removed because of infective endocarditis.

Retrospective chart review was undertaken for 480 patients who underwent a total of 506 valve replacements or repair procedures for infective endocarditis. The influence of preoperative antimicrobial treatment on culture, Gram stain, and histopathological examination findings for resected valve specimens was examined. When valves were removed before the end of treatment, organisms were seen on the Gram stain of ground valve material performed in the microbiology laboratory and on Gram-stained histopathological sections in 231 (81%) of 285 and 140 (67%) of 208 specimens, respectively (P=.

Emotional investments in surgical decision making.

Gordon Smyth had a deep emotional investment in closed cavity surgery for cholesteatoma but, nonetheless, later acknowledged that he believed that he had been mistaken. Emotional investments create problems for all surgeons. Sometimes they have difficulty in recognizing that they need to change what they are doing.